Treatment options for metastatic prostate cancer

First treatment for metastatic prostate cancer

At diagnosis, prostate cancer usually depends on the hormone testosterone to grow. Doctors call it hormone sensitive prostate cancer. Hormone therapy is one of the main treatments for metastatic prostate cancer. It blocks or lowers the amount of testosterone in the body. There are several types of hormone therapy which work in different ways. 

For metastatic prostate cancer, you usually have hormone therapy as your first treatment. Most people have an injection called goserelin. Another option is a hormone drug called degarelix.

You might have this hormone drug on its own. Or you have it together with another hormone drug  such as apalutamide or enzalutamide.

Find out more about hormone therapy for metastatic prostate cancer

Or you might have the 2 different hormone drugs together with a chemotherapy drug called docetaxel. So you have 3 different drug treatments together. This is sometimes called triplet therapy.

Read about chemotherapy treatment for metastatic prostate cancer

You might also have radiotherapy to your prostate and to other areas of cancer in your body. This depends on how much cancer you have in your body. You are more likely to have radiotherapy if your cancer has only spread to a small number of places. 

Read about radiotherapy for metastatic prostate cancer

Treatment for prostate cancer that continues to grow or comes back

Treatment often controls metastatic prostate cancer for many months to years. But sometimes the cancer starts to grow again.

You might hear your doctor saying that you now have:

• castration resistant prostate cancer or

• hormone refractory prostate cancer

This means that hormone therapy is no longer working. Your treatment depends on several factors. This includes what treatment you have had. Your doctor might suggest one or more of the following:

• a different type of hormone therapy

• an additional hormone therapy drug

• chemotherapy with or without steroids

• radiotherapy

• radioisotope therapy such as Radium-223

• a targeted drug called olaparib

Your doctor might ask if you’d like to take part in a clinical trial. Doctors and researchers do trials to make existing treatments better. And to develop new treatments.

Read more about research and clinical trials for prostate cancer

Your choices

Your doctor might offer you a choice of treatments. Discuss each treatment with them and ask how they can control any side effects. This helps you make the right decision for you. You also need to think about the other factors involved in each treatment, such as:

• whether you need extra appointments

• if you need more tests

• the distance you need to travel to and from hospital

You might have to make further choices as your situation changes. It helps to find out as much as possible each time. You can stop a treatment whenever you want to if you find it too much to cope with.

If you decide not to have treatment

You may decide not to have cancer treatments, such as chemotherapy. But you can still have medicines to help control symptoms, such as sickness or pain.

Your doctor or nurse will explain what could help you. You can also ask them to refer you to a local symptom control team to give you support at home.

See what support you can get

How you might feel

When prostate cancer is advanced, it can no longer be cured. Finding out that cancer can’t be cured can be a big shock. It might help to talk to a close friend or relative about how you feel. Your specialist nurse can also offer support and talk to you about what is available for you.

Find out more about the practical and emotional support available